OAS and Out With The Fruit Bowl (at least at my house) October 20, 2011

I scolded my daughter and rolled my eyes when she pleaded, “I don’t want to finish my apples. They’re making my mouth itch and my gums hurt really bad!” What kind of ridiculous nonsense was this? A life-long fruit-lover, this girl would happily substitute fruit for any meal and be out the door, on her way.

As a non-fruit eater, I strongly encouraged fruit-eating for my children’s diets, hoping to create more well-rounded eaters. While I could subsist on veggies alone, I’ve never cared for any fruits and as a rule don’t eat them. My husband has never before or since met anyone who could discount an entire food group.

When day after day, snack after snack was refused by my daughter, I was dumbfounded by her distress when I asked her to finish her fruit after having taken only one bite. I worked for several years in asthma and allergy management, and had not once encountered a food allergy to fruit. She displayed none of the other symptoms associated with food allergies – hives, anaphylaxis or constricted airways. After some research, we determine she is suffering from Oral Allergy Syndrome (OAS) or pollen-food syndrome.

As it turns out, those with hay fever or other pollen allergies, and related disorders such as eczema, can be susceptible to OAS when eating fresh fruit. The reaction is limited to itching, burning and sometimes swelling of the tongue, gums, throat, and ear canal, and is caused when pollens cross over to similar proteins in the fruit.

Sometimes foods in the same botanical family cause reactions. These are potato and carrot; parsley and celery; apple and pear.

Treatment

In most cases, medical treatment is not required. Rapid onset of symptoms can be severe, but dissipate after about 15 minutes. During pollen seasons, treating the hay fever with an antihistamine can reduce the reaction to the fruits. Sometimes milk or mint tea can be helpful for relieving symptoms. Cooking the fruits will change the protein enough that the immune system does not recognize the food as being the same pollen. In severe recurrent cases, OAS may be treated with immunotherapy (allergy shots) to the pollen. Avoidance of the fruits altogether is usually recommended.